Composite
46%
Novelty
50%
Feasibility
30%
Impact
55%
Mechanistic
55%
Druggability
40%
Safety
35%
Confidence
55%

Mechanistic description

Restoration of Neuronal Ketone Body Utilization via MCT1 Upregulation

Evidence for (4)

  • Human AD prefrontal cortex shows 40-60% reduction in MCT1 and MCT4 protein expression compared to age-matched controls

  • Ketogenic diet intervention in MCI patients improves cognitive outcomes and increases serum ketone bodies

  • Mouse model of AD (APP/PS1) demonstrates that ketone supplementation improves mitochondrial function only when MCT expression is preserved

  • CSF β-hydroxybutyrate levels correlate inversely with dementia severity

Evidence against (4)

  • Ketogenic diets show limited CNS ketone uptake in humans - using 11C-acetoacetate PET, ketones enter brain but uptake saturates at physiological levels

  • Clinical trials of ketone esters in AD show modest brain uptake - cerebral metabolic improvement is limited

  • MCT1 has bidirectional transport function - upregulation could increase lactate efflux from neurons, potentially worsening energy balance

  • APP/PS1 mouse models may not recapitulate human AD ketone metabolism - species differences in MCT expression patterns are significant

Bayesian persona consensus

60% posterior support

4 signals · 3 for / 1 against · agreement 75%

scidex.consensus.bayesian compounds vote / rank / fund signals from 4 contributing personas in log-odds space, weighted by uniform. Prior 50%.